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Bile Duct Cancer (Cholangiocarcinoma)

A rare cancer that forms in the bile ducts. A bile duct is a tube that carries bile (fluid made by the liver) between the liver and gallbladder and the small intestine.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Bile Duct Cancer (Cholangiocarcinoma)

Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts.

A network of tubes, called ducts, connects the liver, gallbladder, and small intestine. This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats during digestion). The small ducts come together to form the right and left hepatic ducts, which lead out of the liver. The two ducts join outside the liver and form the common hepatic duct. The cystic duct connects the gallbladder to the common hepatic duct. Bile from the liver passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder.

When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine.

Bile duct cancer is also called cholangiocarcinoma... Read more about Bile Duct Cancer

What works? Research summarized

Evidence reviews

System evaluation of intraluminal brachytherapy (ILBT) combined with endoprostheses compared with endoprostheses alone for nonresectable bile duct cancer

Bibliographic details: Huang X, Wu T X.  System evaluation of intraluminal brachytherapy (ILBT) combined with endoprostheses compared with endoprostheses alone for nonresectable bile duct cancer. Chinese Journal of Evidence-Based Medicine 2009; 9(2): 239-242

Routine diversion of food for patients with unresectable periampullary cancers without obstruction to the stomach outlet

Periampullary cancer is cancer that forms near the junction of the lower end of the common bile duct (the channel that transmits bile from the liver to the small bowel), pancreatic duct, and the upper part of the small bowel. Four‐fifths of these tumours are not amenable to surgical removal (unresectable periampullary cancer). Because of its close proximity to the stomach outlet, these periampullary cancers can cause obstruction to the stomach outlet and prevent the flow of food from the stomach to the small bowel. While diversion of food by way of joining the stomach to the upper small bowel (gastrojejunostomy) or inserting a duodenal stent across the obstructed part of the small bowel is necessary for patients who have established stomach outlet obstruction, the role of prophylactic gastrojejunostomy in patients without established stomach outlet obstruction is controversial. The aim of this review was to determine whether prophylactic gastrojejunostomy should be performed routinely in patients with unresectable periampullary cancer. We searched for randomised controlled trials comparing prophylactic gastrojejunostomy versus no gastrojejunostomy in patients with unresectable periampullary cancer. Two review authors independently assessed the studies for inclusion and extracted data.

Biliary drainage before major operations in patients with obstruction of the bile duct

The liver has various functions, including the production and storage of substances necessary for the sustenance of life. It processes toxic substances (including those that are produced within the body because of the breakdown of old red cells) and plays a role in the excretion of these processed toxic substances. It produces bile, which contains substances necessary for the digestion of food. The bile is temporarily stored in the gallbladder and reaches the small bowel via the bile duct, usually in response to a stimulus such as ingestion of fatty food. The processed toxic substances are transported in the bile. These processed toxic substances are eventually excreted when the person opens his or her bowel. When there is obstruction to the flow of bile, the breakdown products of red cells can accumulate and cause yellowish discolouration of the skin and other linings in the body such as the white of the eyeball and the undersurface of the tongue. This results in a form of jaundice called obstructive jaundice. The obstruction to the bile flow is usually caused by stones in the common bile duct. These stones can originate from the gallbladder or from common bile duct stones. The majority of such stones can be treated endoscopically. However, a small proportion of the stones require surgery for removal. Other major causes of biliary obstruction include narrowing of the bile duct resulting from inflammation caused by stones, injury to the bile duct during operations to remove the gallbladder, and cancer of the bile duct, pancreas (an organ situated behind and below the stomach that secretes the digestive juices necessary for the digestion of food in addition to containing the cells that secrete insulin in order to maintain blood sugar levels), or the upper part of the small bowel called the duodenum. Operative removal is currently the only curative treatment available for these cancers. Such operations are typically major operations. However, the presence of toxic substances because of obstruction to the bile flow can result in physiological disturbances. Some surgeons perform certain procedures to temporarily drain the bile before performing the major operation to remove biliary obstruction due to stones, inflammation, or cancer. These pre‐operative procedures can be done endoscopically (by introducing an instrument equipped with a camera through the mouth and into the small intestine and then inserting a small drainage tube through that instrument and past the obstruction in the bile duct) or under X‐ray or other forms of image guidance via the liver. However, other surgeons argue that the temporary procedures to drain the bile are not necessary and that one should perform surgery directly. We sought evidence from randomised clinical trials only regarding this controversy. Such studies, when conducted properly, provide the best evidence. Two authors independently identified the trials and obtained the information from the trials.

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Summaries for consumers

Bile Duct Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of bile duct cancer.

Routine diversion of food for patients with unresectable periampullary cancers without obstruction to the stomach outlet

Periampullary cancer is cancer that forms near the junction of the lower end of the common bile duct (the channel that transmits bile from the liver to the small bowel), pancreatic duct, and the upper part of the small bowel. Four‐fifths of these tumours are not amenable to surgical removal (unresectable periampullary cancer). Because of its close proximity to the stomach outlet, these periampullary cancers can cause obstruction to the stomach outlet and prevent the flow of food from the stomach to the small bowel. While diversion of food by way of joining the stomach to the upper small bowel (gastrojejunostomy) or inserting a duodenal stent across the obstructed part of the small bowel is necessary for patients who have established stomach outlet obstruction, the role of prophylactic gastrojejunostomy in patients without established stomach outlet obstruction is controversial. The aim of this review was to determine whether prophylactic gastrojejunostomy should be performed routinely in patients with unresectable periampullary cancer. We searched for randomised controlled trials comparing prophylactic gastrojejunostomy versus no gastrojejunostomy in patients with unresectable periampullary cancer. Two review authors independently assessed the studies for inclusion and extracted data.

Biliary drainage before major operations in patients with obstruction of the bile duct

The liver has various functions, including the production and storage of substances necessary for the sustenance of life. It processes toxic substances (including those that are produced within the body because of the breakdown of old red cells) and plays a role in the excretion of these processed toxic substances. It produces bile, which contains substances necessary for the digestion of food. The bile is temporarily stored in the gallbladder and reaches the small bowel via the bile duct, usually in response to a stimulus such as ingestion of fatty food. The processed toxic substances are transported in the bile. These processed toxic substances are eventually excreted when the person opens his or her bowel. When there is obstruction to the flow of bile, the breakdown products of red cells can accumulate and cause yellowish discolouration of the skin and other linings in the body such as the white of the eyeball and the undersurface of the tongue. This results in a form of jaundice called obstructive jaundice. The obstruction to the bile flow is usually caused by stones in the common bile duct. These stones can originate from the gallbladder or from common bile duct stones. The majority of such stones can be treated endoscopically. However, a small proportion of the stones require surgery for removal. Other major causes of biliary obstruction include narrowing of the bile duct resulting from inflammation caused by stones, injury to the bile duct during operations to remove the gallbladder, and cancer of the bile duct, pancreas (an organ situated behind and below the stomach that secretes the digestive juices necessary for the digestion of food in addition to containing the cells that secrete insulin in order to maintain blood sugar levels), or the upper part of the small bowel called the duodenum. Operative removal is currently the only curative treatment available for these cancers. Such operations are typically major operations. However, the presence of toxic substances because of obstruction to the bile flow can result in physiological disturbances. Some surgeons perform certain procedures to temporarily drain the bile before performing the major operation to remove biliary obstruction due to stones, inflammation, or cancer. These pre‐operative procedures can be done endoscopically (by introducing an instrument equipped with a camera through the mouth and into the small intestine and then inserting a small drainage tube through that instrument and past the obstruction in the bile duct) or under X‐ray or other forms of image guidance via the liver. However, other surgeons argue that the temporary procedures to drain the bile are not necessary and that one should perform surgery directly. We sought evidence from randomised clinical trials only regarding this controversy. Such studies, when conducted properly, provide the best evidence. Two authors independently identified the trials and obtained the information from the trials.

See all (24)

Terms to know

Adenocarcinoma
Cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, or other fluids. Most cancers of the breast, pancreas, lung, prostate, and colon are adenocarcinomas.
Bile
Fluid made by the liver and stored in the gallbladder that helps break down fats and get rid of wastes in the body.
Bile Ducts
Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion.
Distal
In medicine, refers to a part of the body that is farther away from the center of the body than another part. For example, the fingers are distal to the shoulder. The opposite is proximal.
Gallbladder
The organ that stores the bile made in the liver and that is connected to the liver by bile ducts. The gallbladder can store about 2 tablespoons of bile. Eating signals the gallbladder to empty the bile through the bile ducts to help the body digest fats.
Hepatic
Related to the liver.
Hilum
A notch in or opening from a bodily part.
Liver
The largest abdominal organ. The liver carries out many important functions, such as making important blood proteins and bile, changing food into energy, and cleaning alcohol and poisons from the blood.
Perihilar
Surrounding the hilum.
Small Intestine
The organ where most digestion occurs. It measures about 20 feet and includes the duodenum, jejunum, and ileum.

More about Bile Duct Cancer

Photo of an adult

Also called: Bile duct adenocarcinoma, Bile duct carcinoma, Cholangiocellular carcinoma

See Also: Extrahepatic Bile Duct Cancer, Intrahepatic Bile Duct Cancer

Other terms to know: See all 10
Adenocarcinoma, Bile, Bile Ducts

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